Multiple basal cell carcinomas following x-ray treatment of tinea capitis in childhood: A case report and a literature review

Abstract

Introduction: Basal cell carcinoma (BCC) is the most frequent skin cancer with a rising incidence worldwide. Predilection sites are the head and the neck in 80-85% of cases. Leading risk factors are sun exposure and ionizing radiation. In the middle of the 20th century, radiation-induced epilation was used as an efficient treatment method for tinea capitis. Patient review: We report a case of an 80-year-old man with a 16year history of the successive occurrence of multiple BCCs on the scalp, face, and neck. He also had the history of tinea capitis treated with radiotherapy during childhood. At presentation during clinical and dermoscopic examination approximately 25 BCCs were observed, predominantly on the scalp. The most common BCC lesion was the nodular subtype, followed by the pigmented and superficial subtypes. Histopathological examination confirmed the diagnosis of BCC in multiple lesions and one squamous cell carcinoma (SCC). In personal history, the most important comorbidity was hairy cell leukemia. The therapeutic approach included surgery and 5-fluorouracil 5% cream. Conclusion: Radiation-induced epilation was used as an efficient method for treating tinea capitis. One of its side effects was the appearance of BCC in radiation exposed areas. Surgical excision is the gold standard for BCC treatment. Also, 5-fluorouracil 5% cream may be a good option for patients with multiple BCCs. We present satisfactory results after combined treatment in our patient.